BRCA1 mRNA在非小细胞肺癌中的表达及预后意义

Expression of BRCA1 in non-small cell lung cancer and its significance in prognosis

目的探讨BRCA1 mRNA在非小细胞肺癌(NSCLC)中表达及与预后的关系。方法选择75例ⅢB/IV期NSCLC患者的甲醛固定-石蜡包埋(FFPE)组织标本。用Trizol一步法提取RNA,RT-PCR检测BRCA1 mRNA基因表达水平。并对化疗疗效及生存时间进行统计分析。结果75例标本BRCA1 mRNA均有表达,以中位数0.52为界,36例高表达,39例低表达。表达高低与临床分期密切相关(P=0.013),与年龄、性别、组织类型无显著性相关,P>0.05。BRCA1低表达患者有明显较高的有效率41.0%(16/39),而BRCA1高表达组有效率为19.4%(7/36),P=0.043。KPS评分高者(80～100分)有效率高,但无统计学意义,P=0.061。疗效与年龄、组织类型、临床分期以及化疗方案无显著相关性,P>0.05。BRCA1低表达、高表达者患者中位OS分别为14个月、10个月,1年生存率分别为56.4%(22/39)、27.8%(10/36),2年生存率分别为38.5%(15/39)、11.1%(4/36),Log-rank检验,P=0.003。OS与临床分期(P=0.044),KPS评分(P=0.004)显著性相关。COX回归分析显示:BRCA1 mRNA为NSCLC患者独立预后影响因素,P=0.021。结论BRCA1 mRNA表达可作为NSCLC化疗敏感性及预后预测因素。

Objective To investigate the expression of BRCA1 and prognostic significance of non-small cell lung cancer （NSCLC）. Methods Formalin-fixed and paraffin-embedded. （FFPE） specimens from 75 NsCLC patients with stage Ⅲ B/ⅣV were obtained and the total RNA was extracted by using Trizol one-step method. Real-time quantitative polymerase chain reaction （RT-PCR） was used to detect the transcription level of BRCA1 gene. The data of therapeutical effect and survival time were collected and analyzed. Results BRCA1 mRNA was expressed in all 75 FFPE specimens, being highly expressed 39 cases,lowly expressed in 36 cases using 0.52 as cut-off value. Expression level of BRCA1, mRNA correlated significantly with clinical TNM stage,P=0.013. There no significant correlation of BRCA1 mRNA expression with age, gender, histology was observed （P〉0.05）. The total effectibe rate （CR＋PR） was 30.7% （23/75）, There no obvious correlation of therapeutic effect with age, gender,histology,clinical TNM stage,and chemotherapy regimens was observed P〉O.05. Median overall survival of all the patients was 11 months, 1--year survival rate 42.7% （32/75）, 2-year survival 25.3% （19/75）. Them was remarkable correlation between OS and clinical TNM stage （P=0.044）,KPS scores （P= 0.004）. Conclusion BRCA1 expression may be regarded as a factor of chemosensitivity and prognosis predicting of NSCLC patients.